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Vascular > Vascular Test Prep > Flashcards

Vascular Test Prep Flashcards

1
Q

Difference between CVA and TIA?

A

CVA is permanent or semi-permanent impairment, while TIA is a mini stroke, with symptoms lasting under 24 hours.

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2
Q

Vertebral-basilar symptoms (AKA back of the brain symptoms)

A
  • drop attacks
  • blackouts
  • syncope
  • Memory loss
  • Vertigo
  • Dizziness
  • Diplopia
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3
Q

Causes of CVA

A
  1. Cardiac: emboli or cessation of perfusion
  2. Carotid etiology=50%: ischemia, thrombosis-occlusion, emboli to brain
  3. Aneurysm rupture: intracranial hemorrhage, vasospasm
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4
Q

Risk factors of Cerebrovascular Disease (Atherosclerosis):

A 
family history of Peripheral Artery Disease or Heart Disease
Smoking
Old Age
Diabetes Mellitus
Hypertension
High Cholesterol/Hyperlipidemia
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5
Q

What % of population has an intact Circle of Willis?

A

50%

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6
Q

Carotid Artery scanning protocol:

A 
Pt. history
Transverse imaging
Longitudinal imaging
Color Doppler
Spectral Doppler
"mapping" of any areas of flow disturbance
Bruit
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7
Q

ECA is ________, while ICA is _________.

A

medial, lateral

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8
Q

Where do you scan from to get the carotid best?

A

Posterolateral

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9
Q

Anatomical Differences between ICA and ECA:

A
  • Posterior Position of ICA
  • branches of ECA
  • ICA is larger, though not reliable with disease
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10
Q

Doppler waveform differences between ICA and ECA:

A

ICA=low resistance

ECA= high resistance (oscillations with temporal tap)

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11
Q

From the distal CCA, pivot the probe towards the ______ to view ECA, and towards the ______ for the ICA.

A

chin, bed

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12
Q

Which view gives most accurate view of plaque?

A

Transverse

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13
Q

Color scale for arterial scans

A

around 30

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14
Q

Color scale for venous scans

A

around 12

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15
Q

What does Color Doppler Flow Imaging evaluate for? (3 things)

A
  1. presence of flow
  2. direction of flow
  3. quality of flow (laminar vs. turbulent)
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16
Q

Two ways to acquire an angle

A
  1. Rock probe (heel-toe)

2. steer the color box

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17
Q

What does perpenducular incidence look like?

A

both red and blue are seen

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18
Q

Direction of blood flow in neck artery:

A

right side of screen to left

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19
Q

Direction of blood flow in neck vein:

A

left side of screen to right

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20
Q

Bulb of CCA may show

A

Eddy flow/flow separation

21
Q

Maintain a spectral doppler angle as close to ___ as possible.

A

60 degrees

22
Q

Angle correct to _____ wall.

A

posterior

23
Q

Overangle correction results in

A

overestimation of velocities

24
Q

Triangle F=

A

Detected Frequency shift

25
Q

Fo=

A

Transmitted Freq.

26
Q

2=

A

Transmit/receive time

27
Q

c=

A

speed of sound in soft tissue

28
Q

V=

A

velocity of blood

29
Q

Cos Theta=

A

cosign of incidence angle

30
Q

Doppler sample locations

A

Prox, Mid, Dist CCA and ECA, and Dist ICA

31
Q

4 steps to mapping a stenosis:

A
  1. Visualize Plaque
  2. Work Doppler sample volume through the stenotic region (3D)
  3. Record and Measure highest velocity (take 2 or 3 samples)
  4. Sample and record distal to stenosis to detect turbulence (if any)
32
Q

When looking for possible trickle flow, use

A

low scale (reduced PRF)

33
Q

What does NASCET stand for?

A

North American Symptomatic Carotid Endarterectomy Trials

34
Q

What does ACAS stand for?

A

Asymptomatic Carotid Atherosclerosis Study

35
Q

Consensus goals of 2003 Society of Radiologists in US:

A
  • to simplify the confusing array of various criteria

- to standardize categories and thresholds

36
Q

What did the NASCET study show?

A

A benefit to carotid endarterectomy (CEA in SYMPTOMATIC patients with a >/= 70% diameter reduction

37
Q

Consensus recommendations for standardization:

A
  • exams performed by accredited organization
  • Doppler angles should be 60 degrees or less
  • ICA should be interrogated from bulb to distal segment to reach maximu stenotic region
  • Report should include velocities,etc
  • On angiograms, the stenosis should be measured using the NASCET method
  • VELOCITY MEASUREMENTS FOR ICA STENOSIS SHOULD BE OBTAINED FROM THE POINT OF MAXIMUM STENOSIS
38
Q

What is the ICA PSV and ICA EDV for a normal degree of stenosis?

A

PSV= <40

39
Q

What is the ICA PSV and ICA EDV for <50% degree of stenosis?

A

PSV= <40

40
Q

What is the ICA PSV and ICA EDV for a 50-69% degree of stenosis?

A

PSV= 125-230, EDV= 40-100

41
Q

What is the ICA PSV and ICA EDV for a >/=70 but < total occlusion degree of stenosis?

A

PSV=>230, EDV= >100

42
Q

What is the ICA PSV and ICA EDV for near occlustion?

A

PSV= high, low or undetectable; EDV= Variable

43
Q

What is the ICA PSV and ICA EDV for total occlusion?

A

PSV= undetectable, EDV= N/A

44
Q

Three potential characteristics of plaque morphology:

A
  1. Homogenous
  2. Heterogenous
  3. Calcified( presence of acoustic shadow)
45
Q

Indications for imaging the vertebral arteries:

A

Primary: for detection of flow direction
Also: to evaluate for abnormal waveforms indicating stenosis or occlusion

46
Q

Indications for imaging the subclavian arteries:

A

Primary: for detection of subclavian stenosis
Also: to follow up after a difference in arm pressures is detected

47
Q

A _______ gradient between left and right brachial pressures suggests subclavian stenosis?

A

20mmHg, arm with lower pressure has stenosis!

48
Q

When does a subclavian steal occur?

A

When there is an occlusion blocking blood from getting to a subclavian artery, blood is rereouted

49
Q

Early systolic deceleration (ESD)

A

AKA Bunny Rabbit waveforms, changing pressure patterns in the left arm in the presence of proximal subclavian artery stenosis affect the vertebral waveforms.

Vascular (4 decks)

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